Is Laparoscopy Contraindicated for Gallbladder Cancer? A 10-Year Prospective Cohort Study

Yoon, Yoo‐Seok; Han, Ho‐Seong; Cho, Jai Young; Choi, Yo Won; Lee, Woo Hyung; Jang, Jae Yool; Choi, Hanlim

doi:10.1016/j.jamcollsurg.2015.07.010

Cited by 92 publications

(92 citation statements)

References 31 publications

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“…Although conventional abdominal ultrasonography (US) and computed tomography are widely used for preoperative staging, these modalities are limited in their ability to predict the depth of invasion compared with endoscopic, high-resolution, or laparoscopic US, which have higher resolution and thus are better able to delineate the multiple layers of the GB wall [18, 19]. A recent intention-to-treat analysis of intended laparoscopic surgery showed favorable clinical and survival outcomes in patients with GBC who were highly selected by multimodality imaging studies, including endoscopic and laparoscopic US [3, 10]. …”

Section: Resultsmentioning

confidence: 99%

“…Despite limited experiences by experts, laparoscopic extended cholecystectomy has been shown to be safe and feasible in selected GBC patients, with similar results to those of open surgery [3, 5, 7-10, 18, 20-26]. According to published reports, the most commonly performed procedures are wedge liver resection and LN dissection.…”

Section: Resultsmentioning

confidence: 99%

“…Some centers additionally dissect LNs in the posterior superior pancreaticoduodenal area and along the common hepatic artery because of frequent LN metastasis in this area and improved patient survival if removed completely [27-29]. Recent reports have shown that LN dissection can be performed to the same extent in laparoscopic surgery as in the open procedure in selected GBC patients with few intraoperative and postoperative complications [3, 5, 7-10]. The number of retrieved LNs is comparable between laparoscopic and open surgeries.…”

Section: Resultsmentioning

confidence: 99%

“…Although this procedure has been contraindicated in patients with GBC for some time, many recent reports have shown that laparoscopic surgery does not adversely affect the perioperative and survival outcomes of patients with GBC [3-9]. One recent report showed that laparoscopic extended cholecystectomy for GBC achieved an outcome comparable with that of open surgery over long-term follow-up [10]. …”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement

et al. 2018

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Background: Despite the increasing number of reports on the favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC), there is no consensus regarding this surgical procedure. Objective: The study aimed to develop a consensus statement on the application of laparoscopic surgery for GBC based on expert opinions. Methods: A consensus meeting among experts was held on September 10, 2016, in Seoul, Korea. Results: Early concerns regarding port site/peritoneal metastasis after laparoscopic surgery have been abated by improved preoperative recognition of GBC and careful manipulation to avoid bile spillage. There is no evidence that laparoscopic surgery is associated with decreased survival compared with open surgery in patients with early-stage GBC if definitive resection during/after laparoscopic cholecystectomy is performed. Although experience with laparoscopic extended cholecystectomy for GBC has been limited to a few experts, the postoperative and survival outcomes were similar between laparoscopic and open surgeries. Laparoscopic reoperation for postoperatively diagnosed GBC is technically challenging, but its feasibility has been demonstrated by a few experts. Conclusions: Laparoscopic surgery for GBC is still in the early phase of the adoption curve, and more evidence is required to assess this procedure.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement

et al. 2018

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“…Few groups have reported laparoscopic extended cholecystectomy (Agarwal 2015) and even laparoscopic bisegmentectomy (IVb+V) (Machado 2015) but results in the form of recurrence (especially port site metastases) and long term survival are awaited before it can be recommended. Yoon (2015) performed laparoscopic surgery (extended cholecystectomy=32, simple cholecystectomy=13) in 45 patients with suspected early GBC (T1=20, T2=25) and reported 5 year survival of 79%.…”

Section: Short Communicationmentioning

confidence: 99%

Peep Before You Enter – Laparoscopy in Gall Bladder Cancer

Kapoor¹

2017

J Gastrointest Cancer Stromal Tumor

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Gall bladder cancer (GBC) is the commonest biliary tract cancer worldwide. Clinically 'obvious' GBC is usually advanced; a careful search should be made for metastases. In the absence of clinical metastases, resectability should be assessed with CT; PET can complement CT in detecting metastases. Laparoscopy has been used for staging of pancreatic and hepato-biliary cancers. Staging laparoscopy is 'strongly recommended' before laparotomy in GBC; it should be performed in incidental GBC also before reoperation for completion extended cholecystectomy (CEC). Addition of US to laparoscopy can increase the yield and accuracy. Laparoscopic extended cholecystectomy has also been reported. We have described anticipatory extended cholecystectomy (AEC) for thick walled GB; it can also be performed laparoscopically.

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Comparison of oncological outcomes after open and laparoscopic re-resection of incidental gallbladder cancer

Vega

Aretxabala

Qiao

et al. 2020

Journal of British Surgery

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Background The safety and oncological efficacy of laparoscopic re-resection of incidental gallbladder cancer have not been studied. This study aimed to compare laparoscopic with open re-resection of incidentally discovered gallbladder cancer while minimizing selection bias. Methods This was a multicentre retrospective observational cohort study of patients with incidental gallbladder cancer who underwent re-resection with curative intent at four centres between 2000 and 2017. Overall survival (OS) and recurrence-free survival (RFS) were analysed by intention to treat. Inverse probability of surgery treatment weighting using propensity scoring was undertaken. Results A total of 255 patients underwent re-resection (190 open, 65 laparoscopic). Nineteen laparoscopic procedures were converted to open operation. Surgery before 2011 was the only factor associated with conversion. Duration of hospital stay was shorter after laparoscopic re-resection (median 4 versus 6 days; P < 0·001). Three-year OS rates for laparoscopic and open re-resection were 87 and 62 per cent respectively (P = 0·502). Independent predictors of worse OS were residual cancer found at re-resection (hazard ratio (HR) 1·91, 95 per cent c.i. 1·17 to 3·11), blood loss of at least 500 ml (HR 1·83, 1·23 to 2·74) and at least four positive nodes (HR 3·11, 1·46 to 6·65). In competing-risks analysis, the RFS incidence was higher for laparoscopic re-resection (P = 0·038), but OS did not differ between groups. Independent predictors of worse RFS were one to three positive nodes (HR 2·16, 1·29 to 3·60), at least four positive nodes (HR 4·39, 1·96 to 9·82) and residual cancer (HR 2·42, 1·46 to 4·00). Conclusion Laparoscopic re-resection for selected patients with incidental gallbladder cancer is oncologically non-inferior to an open approach. Dissemination of advanced laparoscopic skills and timely referral of patients with incidental gallbladder cancer to specialized centres may allow more patients to benefit from this operation.

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Is Laparoscopy Contraindicated for Gallbladder Cancer? A 10-Year Prospective Cohort Study

Cited by 92 publications

References 31 publications

Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement

Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement

Peep Before You Enter – Laparoscopy in Gall Bladder Cancer

Comparison of oncological outcomes after open and laparoscopic re-resection of incidental gallbladder cancer

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